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Higher energy conversion efficiency of IFBB resulted in higher greenhouse gas (GHG) and energy savings, even though the energy usage for the processing steps were higher compared to AD. Biomass yield was positively related to the savings, providing better GHG and energy savings for grasslands containing invasive species. There were no savings in terms of acidification (AP) and eutrophication potential (EP) for both IFBB and AD, however AP and EP was lower using IFBB compared to AD. Hence, biomass originating from mountainous grasslands with lupine invasion could be effectively utilised with IFBB, as this option had lower environmental impacts and higher energy savings compared to AD. Biomass from non-invaded grasslands could also be converted effectively using IFBB, hence IFBB could be used to utilise the harvested biomass in the situation where the invasion is eliminated.We investigate a new framework for estimating the frequency and severity of losses associated with catastrophic risks such as bushfires, storms and floods. We explore generalized additive models for location, scale and shape (GAMLSS) for the quantification of regional risk factors - geographical, weather and climate variables - with the aim of better quantifying the frequency and severity of catastrophic losses from natural perils. Due to the flexibility of the GAMLSS approach, we find a superior fit to empirical loss data for the applied models in comparison to generalized linear regression models typically applied in the literature. selleck compound In particular the generalized beta distribution of the second kind (GB2) provides a good fit to the severity of losses. Including covariates in the calibration of the scale parameter, we obtain vastly differently shaped distributions for the predicted individual losses at different levels of the covariates. Testing the GAMLSS approach in an out-of-sample validation exercise, we also find support for a correct specification of the estimated models. More accurate models for the losses from natural hazards will help state and local government policy development, in particular for risk management and scenario planning for emergency services with respect to these perils.
To compare clinical efficacy, radiographic outcome, and radiation exposure between mini-open pedicle screw (MPS) fixation with the Wiltse approach and percutaneous pedicle screw (PPS) fixation in treatment of young and middle-aged patients with thoracolumbar burst fractures.
Of 60 patients with thoracolumbar vertebrae fractures treated in our hospital from January 2017 to January 2018, 30 were randomly assigned to the MPS group and 30 were randomly assigned to the PPS group. Clinical efficacy, radiographic outcome, and radiation exposure were compared between the 2 groups.
The average age of patients was 42.2 ± 6.7 years in the MPS group and 43.0 ± 6.9 years in the PPS group (P= 0.668). There was no significant difference between the 2 groups in blood loss, hospital stay, postoperative visual analog scale score for back pain, and Oswestry Disability Index score. The vertebral body height and vertebral body angle of the MPS group were significantly better than those of the PPS group at the last follow-up PPS.
The interhemispheric fissure provides a natural surgical corridor to access tumors of the deep medial surface of the brain. Conventional microscopic approaches to these tumors are limited by the narrow width of the interhemispheric fissure and need for retraction of brain tissue or traversing overlying cortex. Over the last decade, the endoscope has been used to improve visualization of the operative field in neurosurgery, with benefits in terms of surgical ergonomics and extent of tumor resections. In the context of the interhemispheric fissure, an endoscopic approach may improve visualization of some tumors by providing a brighter, more divergent light source at depth and by enabling the operator to inspect around curved structures (e.g., corpus callosum).
In this report, we present a series of 5 cases with tumors at various locations along the anteroposterior extent of the interhemispheric fissure that were resected using an endoscopic ipsilateral interhemispheric approach.
The endoscopic ipsilateral interhemispheric approach is an effective and versatile approach to resection of selected deep medial brain tumors extending anteriorly from the genu of the corpus callosum to the splenium. It has notable advantages over the microscope and can be considered a useful adjunct in the surgeon's armamentarium.
The endoscopic ipsilateral interhemispheric approach is an effective and versatile approach to resection of selected deep medial brain tumors extending anteriorly from the genu of the corpus callosum to the splenium. It has notable advantages over the microscope and can be considered a useful adjunct in the surgeon's armamentarium.
Gender is a complex social determinant of health affected by both social and biological factors. There is a need to investigate the effect of gender on outcomes, in the absence of confounding characteristics, to mitigate disparities in care.
A total of 1970 consecutive patients at a university health system undergoing nonmeningioma supratentorial brain tumor resection over a 6-year period (June 9, 2013-April 26, 2019) were analyzed retrospectively. Coarsened exact matching was used to match patients on demographic factors including history of previous surgery, median household income, and race. Outcomes assessed included readmission, emergency department visit, unplanned reoperation, and mortality within 30 days of surgery. Regression analysis was performed among a prematched population and between the matched cohorts with significance set at a P value <0.05.
Within the matched population, no significant difference was observed between male and female patients in any of the recorded outcomes after nonger follow-up and its interrelation with other social determinants of health contributing to outcome disparity.
Primary central nervous system sarcomas are rare primitive mesenchymal non-meningothelial tumors. Malignant peripheral nerve sheath tumor accounts for 5% of sarcomas, with an incidence of approximately 0.001% and a recognized association with neurofibromatosis type 1. Its intracranial subtype, the so-called malignant intracerebral nerve sheath tumor (MINST), is even more infrequent. Current knowledge about its clinical presentation and best therapeutic management is poor because of the limited number of cases reported in literature. Commonly, intratumoral hemorrhage occurs at the time of diagnosis and, notably, most patients had intracranial hemorrhage prior to definitive diagnosis.
We report a case of MINST in a young boy affected by neurofibromatosis type 1 who presented a spontaneous intracranial hemorrhage, successfully treated with surgery and postoperative adjuvant therapy. The tumor relapsed 1 year after and was successfully retreated with a second surgery.
Malignant intracerebral nerve sheath tumors are rare sarcomas that can be associated with intratumoral hemorrhage at the time of presentation, mostly in patients with neurofibromatosis type 1.
